Women healthcare workers and medical staff with Asian heritage are less likely to be using masks that fit them properly, making them more vulnerable to infection, a report said on Tuesday, calling for more robust equipment testing.
The report published in the journal Anaesthesia looked at studies on different methods used to assess filtration masks, such as the N95 and FFP2 models, used by medical workers in high-risk situations.
The authors said that to ensure that a mask is not liable to leak, it must adequately fit the wearer’s face, adding that this appears to be more important for protection from airborne viral spread than for the filtration capacity of the mask itself.
However, hospitals can sometimes lack the time and resources to test masks, often leaving it up to staff to assess their own equipment.
“Satisfactory airborne protection will only be provided if the filtering face-piece respirators are properly fitted to the individual’s face, providing a tight facial seal,” said coauthor Britta von Ungern-Sternberg, a professor at the University of Western Australia. “Airborne protection is decreased in the presence of a leak, as unfiltered air will be drawn inside the mask.”
Their review drew on pre-pandemic research suggesting that in the highest-level “fit test,” only 85 percent of women could be fitted with a respirator, compared with 95 percent of men, while men were also more likely to find a suitable mask on the first attempt.
They also looked at other research that showed higher initial fit-pass rates in Caucasians (90 percent), compared with Asians (84 percent), and said that particularly low initial fit-pass rates were reported in Asian women, with a reported average of just 60 percent.
In the US, the report said that authorities use a fit-test panel to assess the suitability of the N95 masks provided to healthcare workers, but added that the facial dimensions represented by the panel are based on a cohort of people in which women and Asians are “underrepresented.”
In many countries, women make up at least three-quarters of all healthcare staff.
Health workers have been shown to be at a far higher risk of infection. Research published in The Lancet Public Health journal in July found that early in the pandemic, front-line healthcare workers were more than three times more likely to test positive in Britain and the US than the general population, with the rate rising to five times for ethnic minority medical staff.
That study also found that front-line medical staff who said that they did not have sufficient protective equipment — such as masks, gloves and gowns — were 30 percent more likely to test positive than those who said that they had the proper equipment.
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